- Off-pump Bypass Surgery
- On-pump Bypass Surgery
- Surgical Maze for Atrial Fibrillation
- Bentall Procedure
- Tricuspid Valve Repair
- Laser Lead Extraction
- Aortic Aneurysm Repair
- Carotid Endarterectomy
- Arterial Bypass
- Video Assisted Thoracoscopic Surgery
Off-pump Bypass Surgery:
Off-pump bypass surgery, or beating heart surgery, is performed as a treatment to coronary heart disease. Rather than stopping the heart and using a heart-lung machine as in traditional bypass surgery, the off-pump method allows the surgeon to stabilize a portion of the heart to then bypass the blocked artery. Heart stabilizers are used to restrain the heart one section at a time so the surgeon can operate. Benefits to this type of bypass surgery include a reduced need for blood transfusions, and a reduced risk of bleeding, stroke and kidney failure. Patients with additional diseases like lung disease, kidney failure or peripheral vascular disease are deemed high risk and may benefit from off-pump bypass surgery.
On-pump Bypass Surgery:
On-pump bypass surgery is used to treat coronary heart disease, just as off-pump bypass surgery is. However, during an on-pump surgery, the heart is stopped and a heart-lung machine is used to do the work of the heart while the surgeon performs the bypass. The heart-lung machine receives the blood from the body, and then pumps the blood through an oxygenator where the carbon dioxide is removed and oxygen added, then pumps the blood back to the body. Once the operation is completed, the surgeon gradually allows the patient’s heart to resume its functions.
Surgical Maze for Atrial Fibrillation:
Maze surgery treats atrial fibrillation, a type of heart rhythm disorder. During the procedure, a surgeon creates various cuts in the upper part of the patient’s heart in an intricate pattern, or maze. The incisions are then stitched together, creating scars. These scars, because they don’t carry electrical signals, interfere with the impulses that cause atrial fibrillation. Cryoablation (freezing) or radiofrequency ablation (heating) may be used instead of incisions.
Maze heart surgery is for people of many ages, people who have other open-heart procedures at the same time and people who have previously had heart surgery. It restores a regular, coordinated heartbeat, reduces the need for long-term use of blood thinners, and lowers the risk for blood clots and stroke.
Bentall procedure is a heart surgery that replaces the ascending aorta and aortic valve. The ascending aorta delivers oxygenated blood to the body, while the aortic valve connects the aorta and left ventricle. It involves composite graft replacement of the aortic valve, aortic root and ascending aorta, with re-implantation of the coronary arteries into the graft. This procedure is performed on patients who have aneurysms of the aorta. An aneurysm can weaken the aorta, and replacement can prevent it from dissecting, or splitting open.
Tricuspid Valve Repair:
Tricuspid valve repair is performed when a tricuspid valve is floppy or prolapses. During the procedure, an annuloplasty, a technique performed on the ring of tissue that supports the valve’s leaflets, is used. Annuloplasty rings are used to downsize an abnormally large tricuspid valve so that it can close properly. Sutures are sewn around the ring to make the opening smaller. Advantages to tricuspid valve repair include improved life expectancy, better preservation of native heart function, avoidance of long-term use of blood thinners, and lower chance of the patient needing a pacemaker.
Laser Lead Extraction:
A pacemaker or implantable cardioverter defibrillator delivers energy to the heart muscle through wires called leads. During a laser lead extraction, one or more leads is removed from inside the heart. This procedure is needed when leads are not working properly. This can be caused by damage to the lead, large amounts of scar tissue forming at the tip of the lead or infection at the site of the device or lead implant.
Lead extraction can be performed at one of two sites – subclavian vein in the upper chest or the femoral vein in the groin. An incision or small puncture is made and a plastic, hollow tube called a sheath is placed in the vein and guided to the tip of the lead. The sheath holds the heart muscle in place while the lead is removed. A laser is used to remove scar tissue from the lead. New leads will often be implanted.
Aortic Aneurysm Repair:
Endovascular aortic aneurysm repair is surgery to fix a widened section of the aorta, which is the artery that carries blood to the belly, pelvis and legs. This type of procedure is done when a patient’s aneurysm is very large, growing quickly or is leaking or bleeding. Through a small incision in the groin, catheters are guided to deliver a stent-graft to the site of the aneurysm, which diverts blood flow away and reinforces the weak spot of the aorta. This procedure is used to treat abdominal and descending thoracic aneurysms.
Aneurysms that occur in the chest are called thoracic aortic aneurysms and are most often formed by a hardening of the arteries. This risk increases in patients who are smokers, are overweight, have high blood pressure, or have family history of cardiovascular or peripheral vascular disease. In a repair, the weakened vessel is surgically removed and replaced with a graft of artificial material.
A carotid endarterectomy is a surgical procedure during which plaque is removed from the inner lining of the carotid artery. An incision is made on one side of the neck to expose the blocked artery. The carotid artery will be clamped and an incision will be made in the blocked section. The plaque deposit is peeled out by removing the inner lining of the diseased section of the artery containing the plaque. The artery will be stitched, the clamp will be removed and the incision in the neck will be closed.
Patients may be candidates for the procedure if they have severe narrowing of the carotid artery or experience TIAs. Patients who have had a large stroke without recovery, high blood pressure that is not adequately controlled by medication, unstable chest pains, congestive heart failure or signs of progressive brain disorders may also be eligible.
Surgical bypass treats narrowed arteries by creating a bypass around the section of the artery that is blocked. During the procedure a new pathway for blood flow is created using a graft. The graft can either be a portion of a vein or a man-made synthetic tube that connects above and below to allow blood to pass around it. Bypasses are performed on heart arteries, but can also treat peripheral artery disease to bypass arteries in the legs and arms. Femoral popliteal bypass treats femoral artery disease. Subclavian procedures bypass arteries in the upper chest.
Video Assisted Thoracoscopic Surgery:
Video assisted thoracoscopic surgery (VATS) is a minimally invasive surgical procedure used to diagnose and treat problems in the chest and perform biopsies.
During the procedure, a small video camera is introduced in the patient’s chest through a scope, allowing the surgeon to view the anatomy along with other surgical instruments that are introduced during the procedure. It can be used for many purposes, from performing biopsies to removing entire sections of the lungs. It is also useful for diagnosing certain pneumonia infections, diagnosing infections or tumors of the chest wall, and treating repeatedly collapsing lungs.
An esophogastrectomy is a procedure for the treatment of esophageal disorders. During the procedure, part of the lower esophagus, nearby lymph nodes and the upper part of the stomach are removed. The esophagus is either attached directly to the stomach, or the removed section will be replaced with a piece of intestine. The most common reason for the procedure is to treat cancer, however it can also be used to treat achalasia (the esophagus does not work well), pre-cancerous changes in the tissue of the esophagus such as in Barrett’s Esophagus, or severe trauma.